Formal written dispute within 60 calendar days of the Reconsideration Determination Letter; include written statement, copy of the determination and the portal tracking number if applicable.
Appeals and Grievances — clinical documentation fax
Official page read
Phone
No phone listed for this route
Fax
646-313-4618
Supporting clinical documentation for appeals; completed member complaint forms.
Published hours
Not published in this record
Product, plan and location
Confirm the exact product or service New York
Mailing addressHealthfirst Appeals and Grievances Department
P.O. Box 5166
New York, NY 10274-5166
Written member complaints and appeals.
Fax for clinical information supporting expedited or standard appeals and for member complaint forms. Mailing address for appeals and grievances: Healthfirst Appeals and Grievances Department, P.O. Box 5166, New York, NY 10274-5166.
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Find appeal teams, faxes and mailing addresses. Use the denial notice to confirm the appeal level, filing deadline and recipient.
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Denial notice, remittance and reason codes
Previous appeal confirmation and decision
Supporting evidence and any required authorization to represent the member
Questions to resolve
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This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.
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